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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of secondary and curable hypertension was studied retrospectively in 1000 patients. The concept of "secondary hypertension" was used when hypertension was combined with a disease which may have affected the individual's blood pressure. When this definition was applied, 47 of the patients displayed some form of secondary hypertension: stenosis of the renal artery in 10, renoparenchymal disease in 21, hydronephrosis in 3, and endocrine hypertension in 13 (8 of the latter were using oral contraceptives). The blood pressure normalized in 11 and improved in 7 of these patients after operative treatment of the underlying disease or, when appropriate, discontinuance of intake of contraceptive pills. The incidence of secondary hypertension in this and other series is low, and the number of patients with curable hypertension is even lower. In the majority of cases, secondary hypertension can be diagnosed by anamnesis, physical examination and simple tests of blood and urine. If this basic investigation can be extended, the incidence of stenosis of the renal artery should be examined in the first place. Hypertension in young patient and in patients who are difficult to treat often justifies a more extensive investigation.
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PMID:The prevalence of secondary and curable hypertension. 725 63

The clinical, radiological and therapeutic aspects of 8 patients with parapelvic cyst of the kidney are reviewed. The principal clinical features were either renal colic or dull loin pain. The main radiological findings consisted of a rounded smooth mass distorting the pelvis and elongating or dilating the calices. Complications were infection, stone, hypertension or hydronephrosis. Operation was required in 6 patients, 2 of whom underwent nephrectomy.
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PMID:The parapelvic renal cyst. A report of 8 cases with particular emphasis on diagnosis and management. 742 7

We report 2 cases of complete uterine prolapse and bilateral severe hydronephrosis. Although vaginal hysterectomy corrected the obstruction the development of post-obstruction atrophy was associated with hypertension and moderate renal failure. Early diagnosis and correction are required to prevent these sequelae.
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PMID:Uterine prolapse and renal dysfunction. 744 44

ESWL of urinary stones is a well-established treatment in adult patients. The treatment of urinary stones in children has gained increasing importance in recent years. From 1987 to 1993, a series of 27 children with urolithiasis in all parts of the urinary tract were treated by ESWL. Treatment was performed with general anaesthesia or analgosedation. During the treatment no complications occurred. On average, 34 sessions of ESWL, with 2165 shockwaves and 22.3 kV energy, were performed. Minor early complications, such as fever, pain and hydronephrosis, were observed in 7 patients. The overall stone clearance rate was 92%. Stone recurrence occurred in only 1 patient. There were no late complications, such as malfunction of the kidney, skeletal deformation or hypertension after 38 months of follow up. In conclusion, ESWL is the treatment of first choice in paediatric urolithiasis.
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PMID:[Extracorporeal shockwave lithotripsy in children. Complications and long-term results]. 767 42

Initial CT grading of renal injury was correlated with the frequency of complications and the time course of healing in 35 children. All renal contusions (grade 1, 8) and small parenchymal lacerations (grade 2, 8) healed without complications. All lacerations extending to the collecting system (grade 3, 9) resulted in mild to severe loss of renal function with progressive healing over 4 months. One of four segmental infarcts (grade 4A), and five of six vascular pedicle injuries (grade 4B) resulted in severe loss of renal function. Complications, including urinoma (2), sepsis (1), hydronephrosis (1), and persistent hypertension (2), were limited to grade 3 and 4 injuries. Our results suggest that mild renal injuries do not require follow-up imaging. Major renal lacerations and vascular pedicle injuries, however, often result in loss of renal function and should be followed up closely due to the risk of delayed complications. Follow-up examinations should continue for 3-4 months until healing is documented.
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PMID:Blunt renal trauma in children: healing of renal injuries and recommendations for imaging follow-up. 772 79

A 39-year-old male presented with gross hematuria and left lower abdominal discomfort. Excretory urography showed a left ureteral stone and hydronephrosis. CT scans and magnetic resonance imaging showed a solid mass at the upper pole of the left kidney. Angiography revealed a hypervascular lesion at this area. The laboratory data showed a slightly decreased serum potassium level. In the endocrinological study, the serum deoxycorticosterone (DOC) level was markedly elevated. There was, however, no evidence of hypertension. The operation was performed on November 13, 1992. The tumor was almost separated from the left kidney, but an aberrant artery which divided from the renal artery and penetrated the renal parenchyma was found. Therefore, we had to carry out en bloc removal of the tumor together with the left kidney and the ureter which contained the ureteral stone. Pathological diagnosis was adrenocortical carcinoma. After the operation, hypokalemia and the serum concentration of DOC returned to normal range. Therefore, the tumor was diagnosed as DOC producing adrenocortical carcinoma. The patient was discharged 30 days after the operation with uneventful postoperative course. He received 2.5 g of op'-DDD a day. There was no evidence of distant metastasis or local recurrence 12 months after the operation. Nineteen cases of DOC producing adrenocortical tumor have been reported in the world literature. A case and a review of the literature are herein reported.
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PMID:[Deoxycorticosterone-producing adrenocortical carcinoma--a case report]. 777 67

A total of 70 patients with renal trauma were treated at the Department of Urology, Nara Medical University and Nara Prefectural Hospital, including Life-Saving Emergency center, from January 1982 to June 1993. They were between 3 and 79 years old (mean 30.0) and preponded to the younger generation. The main cause of injury was traffic accident in 46 cases (65.7%). According to the Classification of Renal Injury by the Japanese Association for the Surgery of Trauma in Japan, there were 31 cases (44.3%) of type I (subcapsular injury), 18 cases (25.7%) of type II (superficial injury), 15 cases (21.4%) of type III (deep injury), and 6 cases (8.6%) of type IV (pedicle injury). Surgical treatment was performed in 17 cases (24.2%). The major associated injuries were bone fracture in 32 cases (45.7%), lung injury in 17 cases (24.2%), and liver injury in 15 cases (21.4%). Furthermore, hydronephrosis and ureteral tumors were incidentally found in 4 and 1 patient during the course of treatment for renal trauma. Post-traumatic plasma renin activities (PRA) in types III and IV were significantly higher than those in types I and II. Hypertension developed in 1 case of types I and II and 4 cases of types III and IV. The mean level of PRA was significantly decreased 2 years after renal injury in both groups. We should bear in mind that renal trauma may be associated with other urological diseases such as hydronephrosis and urological malignancies, and post-traumatic PRA should be followed carefully.
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PMID:[Clinical studies of renal trauma]. 783 83

To evaluate the role of laparoscopic nephrectomy in the management of benign renal diseases, 12 patients undergoing laparoscopic nephrectomy were compared to 13 undergoing a classical flank nephrectomy. Both groups were similar in regard to patient age and indications for surgery. The underlying pathological conditions included vesicoureteral reflux, tuberculosis, hydronephrosis, hypertension and failed pyeloplasty. Overall, operative time ranged from 105 to 360 minutes (mean 145) for the laparoscopic group and 60 to 240 minutes (mean 156.6) for the open surgery group. Hospital stay and interval to return to regular preoperative activities were 2 to 6 days (mean 3.5) and 10 to 21 days (mean 16) for patients undergoing laparoscopic nephrectomy, which was significantly shorter than for those undergoing a flank procedure, 3 to 16 days (mean 8) and 35 to 84 days (mean 32.3), respectively. Pain medication requirements were also markedly decreased after laparoscopic nephrectomy. Of the patients in the laparoscopic group 2 experienced complications with only 1 requiring conversion to open nephrectomy. The laparoscopic technique is an effective as the flank approach for benign renal conditions, while providing a more rapid recuperation and superior cosmetic result.
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PMID:Comparison between standard flank versus laparoscopic nephrectomy for benign renal disease. 786 91

We retrospectively reviewed 51 pediatric cases of unilateral renal agenesis to determine the incidence of contralateral vesicoureteral reflux. Initial diagnosis of unilateral renal agenesis was made by evaluation of associated congenital abnormality in 21 patients, evaluation of prenatally detected abnormality in 11, evaluation of urinary tract infection in 7, sibling screening in 3, hypertension in 2 and other methods in 7. A voiding cystourethrogram was obtained in 44 cases. Indications for the study included urinary tract infection in 11 patients, hydronephrosis in 18 and screening in 15. Overall, vesicoureteral reflux occurred in 19 of the 51 patients (37%). The highest incidence of contralateral reflux was in those with a prenatal abnormality with or without hydronephrosis (77%) although 5 of 15 patients (33%) who underwent a screening voiding cystourethrogram had reflux. Mean followup was 50 months. Of the patients with vesicoureteral reflux reimplantation was performed in 9, reflux spontaneously resolved in 3 and reflux persisted in 7. There is a high incidence of vesicoureteral reflux in children with unilateral renal agenesis and a voiding cystourethrogram is recommended even in the absence of hydronephrosis or urinary tract infection. Although 50% of children in our series underwent surgical intervention, a period of nonoperative observation is warranted.
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PMID:Incidence of vesicoureteral reflux in children with unilateral renal agenesis. 786 21

A 40-year-old man with the complaint of right lower abdominal pain was admitted to our hospital. Urological examinations revealed right giant hydronephrosis and ureteropelvic junction (UPJ) obstruction caused by an aberrant artery. Radiography showed approximately 3,500 ml of fluid in the renal pelvis. Preliminary nephrostomy was performed and about 2,300 ml of fluid was removed. Enhanced computed tomography, angiography, radioisotope examination and pelvic urine analysis indicated that conservative operation in this case was possible and a pyeloplasty was performed. Two years after the operation the right renal function showed improvement with no complication of hypertension. Although nephrectomies have been performed in adult cases with giant hydronephrosis it is important to consider indication for conservative operations in those cases.
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PMID:[A case of adult giant hydronephrosis--a study of indication for kidney conservative operation]. 794 70


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